INTRODUCTION 
• The organs of the integumentary system 
include the skin and its accessory structures 
including hair, nails, and glands, as well as 
blood vessels, muscles and nerves 
• Dermatology is the medical specialty for 
the diagnosis and treatment of disorders of 
the integumentary system.
STRUCTURE OF THE SKIN 
• The skin (cutaneous membrane) covers 
the body and is the largest organ of the body 
by surface area and weight 
• Its area is about 2 square meters (22 square 
feet) and weighs 4.5-5kg (10-11 lb), about 
7% of body weight 
• It is 0.5 – 4 mm thick, thinnest on the 
eyelids, thickest on the heels; the average 
thickness is 1 – 2 mm
STRUCTURE OF THE SKIN 
• It consists of two major layers: 
• outer, thinner layer called the epidermis, 
consists of epithelial tissue (see video) 
• inner, thicker layer called the dermis 
• Beneath the dermis is a subcutaneous 
(subQ) layer (also called hypodermis) 
which attaches the skin to the underlying 
tissues and organs.
EPIDERMIS 
• Covers, protects, and waterproofs. 
• Contains four main layers: 
• Stratum corneum: Keratinized layer. Prevents loss 
or entry of water; protects against pathogens and 
chemicals. 
• Stratum lucidum: Found only on palms of hands 
and soles of feet; protects against UV sunrays to 
prevent sunburn. 
• Stratum granulosum 
• Stratum germinativum: The innermost layer of 
epidermis, is the only layer that undergoes cell 
division & contains melanin & keratin-forming cells.
• The epidermis has a number of important 
characteristics: 
• the epidermis is composed of keratinized stratified 
squamous epithelium 
• it contains four major types of cells: 
• Keratinocytes (90% of the cells) produce keratin which is a 
tough fibrous protein that provides protection. 
• Melanocytes: which produce the pigment melanin that 
protects against damage by ultraviolet radiation 
• Langerhans cells: involved in immune responses, arise 
from red bone marrow 
• Merkel cells: which function in the sensation of touch along 
with the adjacent tactile discs
TYPES OF CELLS IN 
THE EPIDERMIS
• The epidermis, hair, nail, dental enamel, & 
horny tissues are composed of keratin. 
• It is replaced every 3-4 weeks. 
• Skin color depends on: 
1. The amount of melanin & carotene" yellow 
pigment" contained in the skin 
2. The volume of blood containing hemoglobin 
3. The oxygen-binding pigment that circulates in 
the dermis.
DERMIS 
• The dermis has several important 
characteristics: 
• is composed of connective tissue containing 
collagen and elastic fibers 
• contains two layers 
• the outer papillary region consists of areolar 
connective tissue containing thin collagen and elastic 
fibers, dermal papillae (including capillary loops), 
corpuscles of touch and free nerve endings
• The deeper reticular region consists of 
dense irregular connective tissue 
containing collagen and elastic fibers 
adipose cells, hair follicles, nerves, 
sebaceous (oil) glands, and 
sudoriferous (sweat) glands 
• Striae or stretch marks can appear if the 
skin is stretched too much
• Sweat Glands (Sudoriferous):Most numerous on 
palms of hands and soles of feet. 
• Two types are eccrine and apocrine glands. 
• Eccrine Glands: Respond to external 
temperature and psychological stress. 
• Found over most of body but most numerous on 
palms of hands and soles of feet; secrete sweat, which 
helps regulate body temperature and, to a lesser 
degree, excretes wastes such as urea.
• Apocrine or Odoriferous Glands: 
• Found in axilla and genital area. 
• Respond to stress; secrete pheromones, a 
substance with a barely perceptible odor; when 
apocrine secretions react with bacteria, body 
odor results. 
• Ceruminous glands are a type of apocrine 
gland found in the external ear canal. 
• They secrete cerumen, which prevents drying 
of the ear drum and traps foreign substances.
• Sebaceous Glands: Produce sebum, which 
lubricates and protects skin and hair. 
• Cholesterol: Converts to vitamin D when 
exposed to UV lights. 
• Arterioles: Dilate when hot to increase heat 
loss and constrict when cold to conserve 
heat. 
• Constrict in response to stressful situations to shunt 
blood to vital organs.
• Lines of cleavage - “tension lines” in the 
skin indicate the predominant direction of 
underlying collagen fibers 
• Epidermal ridges reflect contours of the 
underlying dermal papillae and form the 
basis for fingerprints (and footprints); their 
function is to increase firmness of grip by 
increasing friction. 
• Dermatoglyphics - the study of the pattern 
of epidermal ridges
CLEAVAGE (TENSION) LINES AND STRIAE 
• Cleavage (tension) lines: 
elastin and collagen fibers 
oriented in some directions 
more than in others 
• Important in surgery 
• If incision parallel to 
lines, there is less 
gapping, faster healing, 
less scar tissue 
• If skin is overstretched, 
striae (stretch marks) occur
HYPODERMIS / SUBCUTANEOUS 
• Connective Tissue: Connects skin 
to muscles; contains white blood 
cells. 
• Adipose Tissue: Contains stored 
energy, cushions bony prominences, 
provides insulation.
ACCESSORY STRUCTURES OF THE 
SKIN 
• include hair, and nails 
• Hairs (pili) have a number of 
important functions: 
• protection 
• reduction of heat loss 
• sensing light touch
THE HAIR 
The hair is also made up of keratinized cells. 
1. Vellus, which is short, pale, and fine hair, is 
located over all of the body. 
2. Terminal hairs, which are dark and coarse, are 
found on the scalp, brows, and, after puberty, on 
the legs, axillae, and perineum.
• Hair is composed of dead, 
keratinized epidermal cells 
• Hair consists of: 
• shaft which mostly projects above the 
surface of the skin 
• root which penetrates into the dermis 
• hair follicle 
• epithelial root sheath – (downward 
continuation of the epidermis) 
• dermal root sheath
NAILS 
 Nails are composed of hard, keratinized 
epidermal cells located over the dorsal 
surfaces of the ends of fingers and toes 
 Each nail consists of: 
free edge 
transparent nail body (plate) with a whitish 
lunula at its base 
nail root embedded in a fold of skin
NAILS
TYPES OF SKIN 
There are two major types of skin: 
thin (hairy) skin covers all body 
regions except the palms, palmar 
surfaces of digits, and soles 
thick (hairless) skin covers the palms, 
palmar surfaces of digits, and soles
AGING EFFECTS 
• wrinkling 
• decrease of skin’s immune responsiveness 
• dehydration and cracking of the skin 
• decreased sweat production 
• decreased numbers of functional melanocytes resulting 
in gray hair and atypical skin pigmentation 
• loss of subcutaneous fat 
• a general decrease in skin thickness 
• an increased susceptibility to pathological conditions 
 Growth of hair and nails decreases; nails may also 
become more brittle with age.
FUNCTIONS OF THE SKIN 
 regulation of body temperature 
 blood reservoir 
 protection 
 cutaneous sensations 
 excretion and absorption 
 synthesis of vitamin D
RELATIONSHIP OF THE 
INTEGUMENTARY SYSTEM TO OTHER 
SYSTEMS
• ENDOCRINE 
• Thyroid affects growth and texture of skin, 
hair and nails. 
• Hormones stimulate sebaceous glands. 
• Sex hormones affect hair growth and 
distribution, fat and subcutaneous tissue 
distribution and activity of apocrine sweat 
glands. 
• Adrenal hormones affect dermal blood 
supply and mobilize lipids from adipocytes.
URINARY 
Kidneys remove waste and maintain normal 
pH. 
Skin helps eliminate water and waste. 
Skin prevents excess fluid loss. 
DIGESTIVE 
Skin synthesizes vitamin D for calcium and 
phosphorous absorption. 
Supplies nutrients while skin stores lipids.
• CARDIOVASCULAR 
• Mast cell stimulation produces localized changes in 
blood flow and capillary permeability. 
• CV system provides nutrients and removes wastes. 
• Delivers hormones and lymphocytes. 
• Provides heat for skin temperature. 
• SKELETAL 
• Skin synthesizes vitamin D needed for calcium and 
phosphorus absorption. 
• Skeletal system provides a framework for skin.
 LYMPHATIC / IMMUNE 
 Skin is first line of defense. 
 Langerhan cells and macrophages resist infection. 
 Mast cells trigger inflammatory responses. 
 Lymphatic system protects skin by sending more 
macrophages and lymphocytes when needed. 
 RESPIRATORY 
 Provides oxygen to and removes carbon dioxide from 
integumentary system. 
 Color of skin and nails can reflect changes in 
respiratory system.
• MUSCULAR 
• Skin synthesizes vitamin D needed for calcium 
absorption for muscle contraction. 
• Gives shape to and supports skin. 
• Contraction of facial muscles allows communication 
through expressions. 
• NEUROLOGICAL 
• Sensory receptors in dermis to touch, temperature, 
pressure, vibration and pain. 
• Provides communication with external environment. 
• Controls blood flow and sweating through 
thermoregulation.
SEASONAL SKIN DISORDERS 
• Spring: Chickenpox, Acne flare-ups 
• Summer: Contact dermatitis, Tinea, 
Candida, Impetigo, Insect bites 
• Fall: Senile pruritus/winter itch, Pityriasis 
rosea, Urticaria, Acne flare-ups 
• Winter: Contact dermatitis of hands, Senile 
pruritus / winter itch, Psoriasis, Eczema 
49

Integumentary system

  • 2.
    INTRODUCTION • Theorgans of the integumentary system include the skin and its accessory structures including hair, nails, and glands, as well as blood vessels, muscles and nerves • Dermatology is the medical specialty for the diagnosis and treatment of disorders of the integumentary system.
  • 3.
    STRUCTURE OF THESKIN • The skin (cutaneous membrane) covers the body and is the largest organ of the body by surface area and weight • Its area is about 2 square meters (22 square feet) and weighs 4.5-5kg (10-11 lb), about 7% of body weight • It is 0.5 – 4 mm thick, thinnest on the eyelids, thickest on the heels; the average thickness is 1 – 2 mm
  • 5.
    STRUCTURE OF THESKIN • It consists of two major layers: • outer, thinner layer called the epidermis, consists of epithelial tissue (see video) • inner, thicker layer called the dermis • Beneath the dermis is a subcutaneous (subQ) layer (also called hypodermis) which attaches the skin to the underlying tissues and organs.
  • 6.
    EPIDERMIS • Covers,protects, and waterproofs. • Contains four main layers: • Stratum corneum: Keratinized layer. Prevents loss or entry of water; protects against pathogens and chemicals. • Stratum lucidum: Found only on palms of hands and soles of feet; protects against UV sunrays to prevent sunburn. • Stratum granulosum • Stratum germinativum: The innermost layer of epidermis, is the only layer that undergoes cell division & contains melanin & keratin-forming cells.
  • 8.
    • The epidermishas a number of important characteristics: • the epidermis is composed of keratinized stratified squamous epithelium • it contains four major types of cells: • Keratinocytes (90% of the cells) produce keratin which is a tough fibrous protein that provides protection. • Melanocytes: which produce the pigment melanin that protects against damage by ultraviolet radiation • Langerhans cells: involved in immune responses, arise from red bone marrow • Merkel cells: which function in the sensation of touch along with the adjacent tactile discs
  • 9.
    TYPES OF CELLSIN THE EPIDERMIS
  • 11.
    • The epidermis,hair, nail, dental enamel, & horny tissues are composed of keratin. • It is replaced every 3-4 weeks. • Skin color depends on: 1. The amount of melanin & carotene" yellow pigment" contained in the skin 2. The volume of blood containing hemoglobin 3. The oxygen-binding pigment that circulates in the dermis.
  • 12.
    DERMIS • Thedermis has several important characteristics: • is composed of connective tissue containing collagen and elastic fibers • contains two layers • the outer papillary region consists of areolar connective tissue containing thin collagen and elastic fibers, dermal papillae (including capillary loops), corpuscles of touch and free nerve endings
  • 13.
    • The deeperreticular region consists of dense irregular connective tissue containing collagen and elastic fibers adipose cells, hair follicles, nerves, sebaceous (oil) glands, and sudoriferous (sweat) glands • Striae or stretch marks can appear if the skin is stretched too much
  • 15.
    • Sweat Glands(Sudoriferous):Most numerous on palms of hands and soles of feet. • Two types are eccrine and apocrine glands. • Eccrine Glands: Respond to external temperature and psychological stress. • Found over most of body but most numerous on palms of hands and soles of feet; secrete sweat, which helps regulate body temperature and, to a lesser degree, excretes wastes such as urea.
  • 17.
    • Apocrine orOdoriferous Glands: • Found in axilla and genital area. • Respond to stress; secrete pheromones, a substance with a barely perceptible odor; when apocrine secretions react with bacteria, body odor results. • Ceruminous glands are a type of apocrine gland found in the external ear canal. • They secrete cerumen, which prevents drying of the ear drum and traps foreign substances.
  • 18.
    • Sebaceous Glands:Produce sebum, which lubricates and protects skin and hair. • Cholesterol: Converts to vitamin D when exposed to UV lights. • Arterioles: Dilate when hot to increase heat loss and constrict when cold to conserve heat. • Constrict in response to stressful situations to shunt blood to vital organs.
  • 20.
    • Lines ofcleavage - “tension lines” in the skin indicate the predominant direction of underlying collagen fibers • Epidermal ridges reflect contours of the underlying dermal papillae and form the basis for fingerprints (and footprints); their function is to increase firmness of grip by increasing friction. • Dermatoglyphics - the study of the pattern of epidermal ridges
  • 22.
    CLEAVAGE (TENSION) LINESAND STRIAE • Cleavage (tension) lines: elastin and collagen fibers oriented in some directions more than in others • Important in surgery • If incision parallel to lines, there is less gapping, faster healing, less scar tissue • If skin is overstretched, striae (stretch marks) occur
  • 23.
    HYPODERMIS / SUBCUTANEOUS • Connective Tissue: Connects skin to muscles; contains white blood cells. • Adipose Tissue: Contains stored energy, cushions bony prominences, provides insulation.
  • 24.
    ACCESSORY STRUCTURES OFTHE SKIN • include hair, and nails • Hairs (pili) have a number of important functions: • protection • reduction of heat loss • sensing light touch
  • 25.
    THE HAIR Thehair is also made up of keratinized cells. 1. Vellus, which is short, pale, and fine hair, is located over all of the body. 2. Terminal hairs, which are dark and coarse, are found on the scalp, brows, and, after puberty, on the legs, axillae, and perineum.
  • 26.
    • Hair iscomposed of dead, keratinized epidermal cells • Hair consists of: • shaft which mostly projects above the surface of the skin • root which penetrates into the dermis • hair follicle • epithelial root sheath – (downward continuation of the epidermis) • dermal root sheath
  • 30.
    NAILS  Nailsare composed of hard, keratinized epidermal cells located over the dorsal surfaces of the ends of fingers and toes  Each nail consists of: free edge transparent nail body (plate) with a whitish lunula at its base nail root embedded in a fold of skin
  • 31.
  • 32.
    TYPES OF SKIN There are two major types of skin: thin (hairy) skin covers all body regions except the palms, palmar surfaces of digits, and soles thick (hairless) skin covers the palms, palmar surfaces of digits, and soles
  • 33.
    AGING EFFECTS •wrinkling • decrease of skin’s immune responsiveness • dehydration and cracking of the skin • decreased sweat production • decreased numbers of functional melanocytes resulting in gray hair and atypical skin pigmentation • loss of subcutaneous fat • a general decrease in skin thickness • an increased susceptibility to pathological conditions  Growth of hair and nails decreases; nails may also become more brittle with age.
  • 36.
    FUNCTIONS OF THESKIN  regulation of body temperature  blood reservoir  protection  cutaneous sensations  excretion and absorption  synthesis of vitamin D
  • 43.
    RELATIONSHIP OF THE INTEGUMENTARY SYSTEM TO OTHER SYSTEMS
  • 44.
    • ENDOCRINE •Thyroid affects growth and texture of skin, hair and nails. • Hormones stimulate sebaceous glands. • Sex hormones affect hair growth and distribution, fat and subcutaneous tissue distribution and activity of apocrine sweat glands. • Adrenal hormones affect dermal blood supply and mobilize lipids from adipocytes.
  • 45.
    URINARY Kidneys removewaste and maintain normal pH. Skin helps eliminate water and waste. Skin prevents excess fluid loss. DIGESTIVE Skin synthesizes vitamin D for calcium and phosphorous absorption. Supplies nutrients while skin stores lipids.
  • 46.
    • CARDIOVASCULAR •Mast cell stimulation produces localized changes in blood flow and capillary permeability. • CV system provides nutrients and removes wastes. • Delivers hormones and lymphocytes. • Provides heat for skin temperature. • SKELETAL • Skin synthesizes vitamin D needed for calcium and phosphorus absorption. • Skeletal system provides a framework for skin.
  • 47.
     LYMPHATIC /IMMUNE  Skin is first line of defense.  Langerhan cells and macrophages resist infection.  Mast cells trigger inflammatory responses.  Lymphatic system protects skin by sending more macrophages and lymphocytes when needed.  RESPIRATORY  Provides oxygen to and removes carbon dioxide from integumentary system.  Color of skin and nails can reflect changes in respiratory system.
  • 48.
    • MUSCULAR •Skin synthesizes vitamin D needed for calcium absorption for muscle contraction. • Gives shape to and supports skin. • Contraction of facial muscles allows communication through expressions. • NEUROLOGICAL • Sensory receptors in dermis to touch, temperature, pressure, vibration and pain. • Provides communication with external environment. • Controls blood flow and sweating through thermoregulation.
  • 49.
    SEASONAL SKIN DISORDERS • Spring: Chickenpox, Acne flare-ups • Summer: Contact dermatitis, Tinea, Candida, Impetigo, Insect bites • Fall: Senile pruritus/winter itch, Pityriasis rosea, Urticaria, Acne flare-ups • Winter: Contact dermatitis of hands, Senile pruritus / winter itch, Psoriasis, Eczema 49

Editor's Notes